Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ryan Black, PA-C

Individual provider Physician Assistant · NPI 1932452091

Ryan Black, PA-C is a Physician Assistant in Rigby, Idaho. Qualified in 2012, 14 years ago. Practices with High Valley Dermatology and Dermatologic Surgery PLLC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
14
Licensed in
TX
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

703 Rigby Lake Dr
Rigby, ID 83442-5192
Phone: (208) 745-0200
Fax: (208) 745-0212
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2085 Providence Way, Idaho Falls, ID 83404-4945 — (208) 516-1846

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (TX)

Record details

NPI number1932452091
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 25, 2012
Last updated in NPPESOctober 24, 2023
Certification dateOctober 24, 2023
Mailing address703 Rigby Lake Dr, Rigby, ID 83442-5192

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice High Valley Dermatology And Dermatologic Surgery Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Rigby